(Photo: John Martinez Pavliga / Flickr)Can football change to minimize the incidence of concussion, chronic traumatic encephalopathy, second impact syndrome and other injuries while retaining speed, strategy and viewer appeal? Maybe not in our lifetimes.

These days, we all know someone affected by dementia or Alzheimer's.

Symptoms of the diseases, such as the inability to recognize loved ones, or manage even the most mundane aspects of daily life, usually occur in later years. But an increasing number of younger adults are also experiencing a profound loss of cognitive capacity and function.

Their condition seems to have little to do with their age - and everything to do with their occupation.

Even if you're not a sports fan, you've probably heard about the proposed $765 million settlement between the National Football League and 4,500 of its former players who filed concussion-related lawsuits.

If approved by District Court Judge Anita B. Brody, all 16,000 of the league's retirees would be eligible for varying degrees of compensation. A portion of the money would also be used to pay for medical exams and research. Under the terms of the agreement, the league would not have to acknowledge liability.

Opinion on the merits of the tentative outcome is divided. Some believe the settlement is a good thing, as players who've suffered from dementia, and an incurable, degenerative disease called chronic traumatic encephalopathy (CTE), would receive financial support sooner, rather than later. Others would prefer to see the case proceed, forcing the league to defend itself against allegations it concealed evidence that showed it knew far more about the risks associated with head injuries than it let on.

Yet another question - one that has haunted the sport since its inception - that lies at the crux of it all: Is there any way to truly make the game of football safer? To answer that question, a bit of background is in order.

With its origins in rugby and soccer, football in America - or at least a version that most of us would recognize - began to take shape in the late 1800's. From the outset, it was violent. Catastrophic injuries were legion, with many attributed to the infamous "flying wedge," which pitted a v-shaped line of offensive blockers, arms locked, running, in advance of the ball-carrier, headlong into an equal number defensive players.

By 1905, things had gotten so far out of control (across the nation, 18 players were fatally injured) that banning the sport was not out of the realm of possibility. That's when none-other than President Theodore Roosevelt weighed in. Shortly thereafter, a series of dramatic rule changes went into effect, including the elimination of the aforementioned mass formations, as well as the legalization of the forward pass.

Still, it would be decades before helmets (albeit, ones without face masks) became mandatory in the NFL. For an even longer period of time, ball-carriers in the pro ranks, after being knocked to the ground, were actually allowed to get up and continue their run - until they were definitively brought to the turf, in the grasp of a defender.

That didn't change until 1956, when the NFL determined that a runner shall be down when any part of his body - other than his hands or feet - touched the playing surface, following contact with an opponent.

Fast forward a half-century. Save for tinkering with the rules to increase scoring (by way of passing, mostly), the sport doesn't look much different. True, safeguards have been put in place to minimize blocks to the knees, and discourage missile-like tackles and blows to the head. But none of those alterations can offset the factors that account for the steady stream of traumatic brain injuries: the freakish size and speed of today's players, coupled with glorification of the game's violence (such as the wildly popular video collection of the sport's most vicious hits - the NFL's version of snuff films).

The human brain, and, for that matter, the rest of our body, wasn't designed to withstand repeated collisions that roughly approximate the force of a car crash - a revelation that has become increasingly apparent as the sport's participants have gotten bigger, faster and stronger. And though we'd like to believe otherwise, football helmets, while protecting against fractures, don't do much to stop concussions, with none proven to prevent the brain from crashing against the side of the skull during a violent exchange (which can happen even when the impact absorbed by a player does not stem from a direct blow to the head).

Compounding matters, surveyed players, be they high school, college, or pro, routinely admit their reluctance to cop to the all-to-common (and frequently invisible) head injury, fearing that they will be held out of action. Often combined with limited medical oversight, it's little wonder that, according to the American College of Sports Medicine, of the 2 million concussions suffered each year by high school athletes - most of whom, are football players - as many as 85 percent go undiagnosed.

The significance of this finding cannot be underestimated, especially for younger athletes, as it can be a precursor to something called Second Impact Syndrome - a rare, but often fatal condition that arises when a child is subjected to consecutive traumas to the head, with the second instance occurring before the initial injury has healed. All previously reported cases have resulted in either permanent brain damage or death.

For adults who play the sport, the effect of repetitive head traumas (which can number in the thousands, depending on the length of one's career) can be summed up with the names Junior Seau, Dave Duerson, Andre Waters and Ray Easterling. All are former NFL stars who, along with dozens of their peers, were diagnosed with CTE postmortem. They are among a growing list of players who've committed suicide - motivated, according to those who knew them best, by the anguish that accompanied their disease.

The debilitating symptoms of CTE include: severe mood changes, ranging from depression to aggression; decreased cognitive function, including memory loss and a reduced capacity to process information; and impaired mobility. Added to the mix is that none of the symptoms can be reversed. It is, by anyone's definition, a distressing way to live - to which I can relate.

Earlier this year, a combination of a virus, an infection and a tumor in my head left me with all of those symptoms, save for the violent outbursts. For weeks, I was completely incapacitated (as in: unable to do anything at all for myself). And while I didn't know it at the time, I was lucky, because most of my symptoms would prove, to varying degrees, reversible.

Over the course of several months, I slowly taught myself how to walk again. Along the way, however, I experienced everything from slurred speech; memory dysfunction (such as the daily occurrence of opening a closet door, instead of the refrigerator, when looking for something to eat); as well as an inability to comprehend the simplest of instructions. In a word, I was terrified - a feeling that did not begin to dissipate until I showed significant signs of recovery.

With due deference to brain surgeons, you don't have to be one to recognize that an untold number of players and their families are destined for a life that none of us would wish. Some, like 17-year-old Nathan Stiles, who died hours after collapsing in a high school football game - and is, to date, the youngest to be diagnosed with CTE - will never even get that far. When asked about the prospect of CTE being in his future, former NFL standout Rodney Harrison, now 40, likely echoed the sentiment of many players, when he replied: "I'm scared to death."

So, what is a player, a parent, or league commissioner to do? Does anyone actually support the idea that the rules of the most popular sport in the United States should be turned on their head, like they were a hundred years ago?

Well, as a matter of fact, I do.

Distilled to its simplest form, football is about one team trying to advance the ball, while its opponent tries to halt them. With few exceptions, a ball-carrier is stopped by way of a tackle. Whenever possible, this maneuver is carried out in a manner - and with anaccompanying intent - that would be criminal were it to occur during our daily flow of life. However, if the definition of a tackle, along with what makes for a legal block, were redefined, the number of collisions in a game or practice would drop exponentially. This new incarnation of the sport would resemble a modified version that most of us are already familiar with: Flag Football.

Now before you dismiss this concept out-of-hand, you should know that I'm not talking about 7 on 7, "count to five" before you rush the quarterback flag football.

Running, passing and kicking - along with speed, strength, size, agility, teamwork and strategy - would remain integral components of the game. The modifications would be as follows: Instead of what now constitutes a tackle, a runner would be down once an opponent removed a flag from the ball-carriers belt. And players would not be allowed to leave their feet to implement a football-move, unless they were trying to catch or deflect a pass, kick or punt (a shift designed, in part, to eliminate high-speed collisions downfield).

The frequency of passing would likely escalate, and most running plays would veer to the outside. Both trends would result in more stand-up linemen on both sides of the line of scrimmage, markedly reducing the under-the-radar brutality inherent in the "trenches." In short, the game would emphasize deception, misdirection and re-direction. It's the violence that would be out of place.

If all of this sounds extreme, consider the alternative: a player killed, in high definition, before your very eyes.

Make no mistake, I'm not naive enough to think that the present generation of players, fans, administrators and assorted profiteers won't put up the fight of their lives to maintain the sport's status quo. On the other hand, our ancestors did have the cojones to make sweeping changes to the game, once player funerals exceeded the number of weeks in a season.

With the inevitable consequences of what amounts to a pay-per-view, player death watch looming on the horizon, the grand ole game faces the sport's ultimate call: fourth and goal, trailing by a touchdown - and time for just one more play.

(Photo: John Martinez Pavliga / Flickr)Can football change to minimize the incidence of concussion, chronic traumatic encephalopathy, second impact syndrome and other injuries while retaining speed, strategy and viewer appeal? Maybe not in our lifetimes.

These days, we all know someone affected by dementia or Alzheimer's.

Symptoms of the diseases, such as the inability to recognize loved ones, or manage even the most mundane aspects of daily life, usually occur in later years. But an increasing number of younger adults are also experiencing a profound loss of cognitive capacity and function.

Their condition seems to have little to do with their age - and everything to do with their occupation.

Even if you're not a sports fan, you've probably heard about the proposed $765 million settlement between the National Football League and 4,500 of its former players who filed concussion-related lawsuits.

If approved by District Court Judge Anita B. Brody, all 16,000 of the league's retirees would be eligible for varying degrees of compensation. A portion of the money would also be used to pay for medical exams and research. Under the terms of the agreement, the league would not have to acknowledge liability.

Opinion on the merits of the tentative outcome is divided. Some believe the settlement is a good thing, as players who've suffered from dementia, and an incurable, degenerative disease called chronic traumatic encephalopathy (CTE), would receive financial support sooner, rather than later. Others would prefer to see the case proceed, forcing the league to defend itself against allegations it concealed evidence that showed it knew far more about the risks associated with head injuries than it let on.

Yet another question - one that has haunted the sport since its inception - that lies at the crux of it all: Is there any way to truly make the game of football safer? To answer that question, a bit of background is in order.

With its origins in rugby and soccer, football in America - or at least a version that most of us would recognize - began to take shape in the late 1800's. From the outset, it was violent. Catastrophic injuries were legion, with many attributed to the infamous "flying wedge," which pitted a v-shaped line of offensive blockers, arms locked, running, in advance of the ball-carrier, headlong into an equal number defensive players.

By 1905, things had gotten so far out of control (across the nation, 18 players were fatally injured) that banning the sport was not out of the realm of possibility. That's when none-other than President Theodore Roosevelt weighed in. Shortly thereafter, a series of dramatic rule changes went into effect, including the elimination of the aforementioned mass formations, as well as the legalization of the forward pass.

Still, it would be decades before helmets (albeit, ones without face masks) became mandatory in the NFL. For an even longer period of time, ball-carriers in the pro ranks, after being knocked to the ground, were actually allowed to get up and continue their run - until they were definitively brought to the turf, in the grasp of a defender.

That didn't change until 1956, when the NFL determined that a runner shall be down when any part of his body - other than his hands or feet - touched the playing surface, following contact with an opponent.

Fast forward a half-century. Save for tinkering with the rules to increase scoring (by way of passing, mostly), the sport doesn't look much different. True, safeguards have been put in place to minimize blocks to the knees, and discourage missile-like tackles and blows to the head. But none of those alterations can offset the factors that account for the steady stream of traumatic brain injuries: the freakish size and speed of today's players, coupled with glorification of the game's violence (such as the wildly popular video collection of the sport's most vicious hits - the NFL's version of snuff films).

The human brain, and, for that matter, the rest of our body, wasn't designed to withstand repeated collisions that roughly approximate the force of a car crash - a revelation that has become increasingly apparent as the sport's participants have gotten bigger, faster and stronger. And though we'd like to believe otherwise, football helmets, while protecting against fractures, don't do much to stop concussions, with none proven to prevent the brain from crashing against the side of the skull during a violent exchange (which can happen even when the impact absorbed by a player does not stem from a direct blow to the head).

Compounding matters, surveyed players, be they high school, college, or pro, routinely admit their reluctance to cop to the all-to-common (and frequently invisible) head injury, fearing that they will be held out of action. Often combined with limited medical oversight, it's little wonder that, according to the American College of Sports Medicine, of the 2 million concussions suffered each year by high school athletes - most of whom, are football players - as many as 85 percent go undiagnosed.

The significance of this finding cannot be underestimated, especially for younger athletes, as it can be a precursor to something called Second Impact Syndrome - a rare, but often fatal condition that arises when a child is subjected to consecutive traumas to the head, with the second instance occurring before the initial injury has healed. All previously reported cases have resulted in either permanent brain damage or death.

For adults who play the sport, the effect of repetitive head traumas (which can number in the thousands, depending on the length of one's career) can be summed up with the names Junior Seau, Dave Duerson, Andre Waters and Ray Easterling. All are former NFL stars who, along with dozens of their peers, were diagnosed with CTE postmortem. They are among a growing list of players who've committed suicide - motivated, according to those who knew them best, by the anguish that accompanied their disease.

The debilitating symptoms of CTE include: severe mood changes, ranging from depression to aggression; decreased cognitive function, including memory loss and a reduced capacity to process information; and impaired mobility. Added to the mix is that none of the symptoms can be reversed. It is, by anyone's definition, a distressing way to live - to which I can relate.

Earlier this year, a combination of a virus, an infection and a tumor in my head left me with all of those symptoms, save for the violent outbursts. For weeks, I was completely incapacitated (as in: unable to do anything at all for myself). And while I didn't know it at the time, I was lucky, because most of my symptoms would prove, to varying degrees, reversible.

Over the course of several months, I slowly taught myself how to walk again. Along the way, however, I experienced everything from slurred speech; memory dysfunction (such as the daily occurrence of opening a closet door, instead of the refrigerator, when looking for something to eat); as well as an inability to comprehend the simplest of instructions. In a word, I was terrified - a feeling that did not begin to dissipate until I showed significant signs of recovery.

With due deference to brain surgeons, you don't have to be one to recognize that an untold number of players and their families are destined for a life that none of us would wish. Some, like 17-year-old Nathan Stiles, who died hours after collapsing in a high school football game - and is, to date, the youngest to be diagnosed with CTE - will never even get that far. When asked about the prospect of CTE being in his future, former NFL standout Rodney Harrison, now 40, likely echoed the sentiment of many players, when he replied: "I'm scared to death."

So, what is a player, a parent, or league commissioner to do? Does anyone actually support the idea that the rules of the most popular sport in the United States should be turned on their head, like they were a hundred years ago?

Well, as a matter of fact, I do.

Distilled to its simplest form, football is about one team trying to advance the ball, while its opponent tries to halt them. With few exceptions, a ball-carrier is stopped by way of a tackle. Whenever possible, this maneuver is carried out in a manner - and with anaccompanying intent - that would be criminal were it to occur during our daily flow of life. However, if the definition of a tackle, along with what makes for a legal block, were redefined, the number of collisions in a game or practice would drop exponentially. This new incarnation of the sport would resemble a modified version that most of us are already familiar with: Flag Football.

Now before you dismiss this concept out-of-hand, you should know that I'm not talking about 7 on 7, "count to five" before you rush the quarterback flag football.

Running, passing and kicking - along with speed, strength, size, agility, teamwork and strategy - would remain integral components of the game. The modifications would be as follows: Instead of what now constitutes a tackle, a runner would be down once an opponent removed a flag from the ball-carriers belt. And players would not be allowed to leave their feet to implement a football-move, unless they were trying to catch or deflect a pass, kick or punt (a shift designed, in part, to eliminate high-speed collisions downfield).

The frequency of passing would likely escalate, and most running plays would veer to the outside. Both trends would result in more stand-up linemen on both sides of the line of scrimmage, markedly reducing the under-the-radar brutality inherent in the "trenches." In short, the game would emphasize deception, misdirection and re-direction. It's the violence that would be out of place.

If all of this sounds extreme, consider the alternative: a player killed, in high definition, before your very eyes.

Make no mistake, I'm not naive enough to think that the present generation of players, fans, administrators and assorted profiteers won't put up the fight of their lives to maintain the sport's status quo. On the other hand, our ancestors did have the cojones to make sweeping changes to the game, once player funerals exceeded the number of weeks in a season.

With the inevitable consequences of what amounts to a pay-per-view, player death watch looming on the horizon, the grand ole game faces the sport's ultimate call: fourth and goal, trailing by a touchdown - and time for just one more play.